Children hardly ever get the connection between these sources and their blues, grumps or irritableness. Even parents may need records of moods and diet to see that some mood swings are related to certain foods.

Allergies don’t always show up as dramatic events such as hives or stomach aches. Allergies and food intolerances can come out as behavioral irritations. Even serious problems such as bipolar disorders or ADHD can be aggravated by allergies and sensitivities to foods.

Since the behavioral problems are usually a part of family interactions, what causes what is difficult to sort out. Keeping a record of your child’s behavior and the foods he eats can be an inconvenient task for parents who already have a full schedule.

Most doctors won’t ask you to keep records, but the information can be very useful whether or not a medication is required. A good way to start is with the most likely culprits: caffeine, sugar, chocolate, eggs, and milk products. Draw up a chart with the days marked down the side and hours across the top. Tape it on the refrigerator.

Record each occasion of the possible culprits and record your rating of your child’s behavior in the hours that follow—1 for no difficulties, 2 for just a slight problem, 3 for getting mad about something trivial, 4 for a big confrontation, 5 for a full, losing-it tantrum. Record everything he eats at all snacks and meals. Often you may find an allergy with no physical symptom. No hives, no itchy eyes or stomach aches, just irritation, prickliness and an occasional tantrum.

Most of the disturbing foods can also disrupt sleep and poor sleeping habits will cause additional behavioral problems. Even timing and quantity of food can disturb sleep and create bad behavior the next day. Overweight children and children who snack too late in the evening can have trouble sleeping.

Since most behavior is partly controlled by what happens before and after, I also ask parents to include a column on the record for what happens just before and then just after the problem. Two hours of TV right before the melt-down or an entertaining argument with Mom every time our little terror delays his homework can indicate an answer that can help as much as any pill.

Medications can be life savers for parents suffering with a severely disturbed child. Drug companies have a right to be proud of the help they provide. But it is not right to belittle environmental effects just because medication can reduce the symptom. Even in severe cases, there are multiple causes and a long-term answer will require that parents discover and deal with these social and environmental causes.